Evidence-based evaluations of dental treatment are needed to support the development of special care dentistry services. This retrospective study was designed to collect and analyse X-ray images of permanent teeth restored with stainless steel crowns (SSC) in patients treated under general anaesthesia. Between 2013 and 2019, 360 permanent molars were crowned with SSCs in 198 adult patients. One calibrated investigator used an original validated tool to evaluate four radiographic criteria for molars restored with SSCs: (i) marginal adaptation; (ii) interdental proximal contact; (iii) the presence of glass ionomer cement overflow; and (iv) the loss of alveolar bone. Overall, no defect or a minor defect was reported for the majority of SSCs for the criteria “Marginal adaptation” (62.5%, n = 320), “Proximal contact” (82.2%, n = 236) and “Cement overflow” (95.8%, n = 337). Alveolar bone resorption was reported in 8.3% of cases, n = 14, after a mean period of 8.9 ± 14.3 months. It was shown that the restoration of permanent teeth using SSCs placed under general anaesthesia presents a low risk of periodontal morbidity in the medium term when assessed radiographically.
Epidemiological data regarding the evolution of problems related to mastication and swallowing with age are lacking. This study aims to (i) describe changes in oral function with age, using data from a large French population, (ii) validate online, self-report uses of an ICF questionnaire in older persons, and (iii) assess whether impairment is related to avoidance of certain foods, xerostomia, body mass index (BMI) and oral health related quality of life (OHRQoL). Volunteers aged ≥18 years with internet access completed a series of questionnaires on sociodemographic, anthropometric and oral health characteristics (oral function, Xerostomia Index (XI), OHRQoL, reasons for avoidance of certain food). Oral function was assessed using items derived from the International Classification of Functioning (ICF). Five ICF items related to ingestion function and six items related to activities and participation were used. A validation study was undertaken to identify those with poor chewing ability and low salivary flow amongst older participants reporting impairment. 39 597 individuals were included. The prevalence of individuals with impairment for ICF items related to ingestion function and oral activity (eating, drinking and speaking), and the percentage of participants with poor OHRQoL increased significantly with age (p < 0.001). Each ICF item was significantly associated with OHRQoL (p < 0.001), XI (p < 0.001), BMI (p < 0.001) and avoidance of certain food due to chewing or swallowing difficulties. Overall, 21.5% and 13.5% of the study population had chewing and/or biting impairments respectively, which might affect food selection and consumption. These findings raise individual and population-based issues. Further studies are needed to assess whether impairment in oral function might increase frailty in older individuals, and also to compare data with those from other countries.
Endodontic treatment is often the first-line procedure to manage the immediate or long-term aftermath of dental trauma, particularly in cases of luxation or avulsion. Failure to manage trauma in the short or medium term leads to significant functional or aesthetic consequences, especially in the adolescence period. Under this specific conditions, endodontic treatment could provide a temporary solution by keeping teeth with poor prognosis on the arch while waiting for better anatomical conditions for implantology. This clinical case aimed to describe the management of a maxilla-facial dental trauma and the following consequences in a 10-year-old male patient. Clinical and radiological examination showed complete extrusive luxation of 11 and 21 and intrusive luxation of 12 and 22. Endodontic treatment of 11 and 21 was performed six months after the trauma. Two years later, the patient was referred to the endodontic department because pink spot lesions appeared on 12 and 22 due to cervical invasive resorptions (class III for 12 and class II for 22). Endodontic treatment of 12 and filling with resin composite of 22 were performed. During the following two years, complication management finally led to placement of four OBI® (Euroteknika, Sallanches, France)-type mini-implants after avulsion of all four maxillary incisors. Palliative endodontic treatment helped maintain the prosthetic space and the volume of supporting tissue needed for future implant placement. The interest of using delaying procedures (palliative endodontic treatments and mini-implants) was to allow the patient to complete growth. Managing early treatment failure of trauma in adolescents has to be pluridisciplinary and should take into account the evaluation of the treatment’s difficulty, the prognosis of the endodontic treatment, the available bone volume and the pubertal growth stage.
Endocrowns are designed to restore endodontically treated teeth with root canal treatment (Rct). Recently, endocrowns were proposed for teeth treated with full pulpotomy (FP). No data exist on in vitro evaluations for this combination. This study aimed to evaluate the mechanical behavior of pulpotomy-treated teeth with endocrowns according to different protocols for preparation design and materials and to assess whether 3D-printed resin simulators could be a reliable alternative for human teeth during in vitro strength tests. One hundred and ten extracted natural molars were randomized into 11 groups according to the type of endodontic treatment, the material used, and the design of peripheric preparation. One hundred and ten resin simulators were separated similarly. The samples were embedded in epoxy resin blocks before being subjected to oblique compressive load until failure. For natural teeth, the variance analysis separated two homogeneous groups, one regrouping the endodontically treated or pulpotomy-treated teeth without coronal restoration and the other one regrouping all the other samples, i.e., the untreated teeth (positive controls) and the treated and restored teeth. The strength resistance was lower for the resin simulators than for natural teeth in all groups. Within the limit of this study, strength resistance is not the most important criterion for choosing the type of material, preparation, or endodontic treatment for endocrowns. Resin simulators are not efficient for in vitro strength studies.